strong medicine 2-25-2014 interview with jeanette ives...
TRANSCRIPT
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Strong Medicine 2-25-2014 Interview with Jeanette Ives-Erickson
HARRISON: [00:00] OK. So this is Emily Harrison, and I’m here
with Jeanette Ives-Erickson at Mass General Hospital.
We’re going to record an interview as part of the Strong
Medicine Oral History Project. Jeanette, do I have your
permission to begin the interview?
IVES-ERICKSON: Absolutely.
HARRISON: All right. So we’re conducting this interview to
create a permanent historical record of the Boston Marathon
bombings and their aftermath. We’ll spend much of our time
together today talking about your experiences of what
happened that day and in the weeks and months and nearly
year that followed. We also want this interview to make
sense to people decades from now, so we’d like to begin by
hearing a little bit about who you are, what your training
background is.
IVES-ERICKSON: So, my title is senior vice president for patient
care and chief nurse. I’ve been a nurse since 1971, I’ve
been at the Mass General since 1988, and have been in this
position since 1996. My clinical background is as a
critical care nurse. Part of my responsibility in the
hospital is as part of our emergency management plan. I’m
what is called the operations chief. So, the person who
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really works to -- on throughput, patient safety, making
sure that the organization is running smoothly while taking
care of the patients we already have as well as any people
that are brought here because of our local disasters. So
I’ve been part of our training team for a very long time,
which is -- and I emphasize that Emily, because I think one
of the things that you’re probably going to hear and your
colleagues are going to hear is that we believe the reason
why we did so well on April 15th last year was because of
all the training.
HARRISON: Yeah. I was wondering if you actually could bring us
into that a bit. What sort of exposure you had to disaster
management response training over the course of your
education and then in your career, if there have been
notable moments and changes.
IVES-ERICKSON: It’s -- so it’s always interesting how as people
ask questions, time, things, events flash through your
head. My very first crisis was as a staff nurse. When I
was working in an intensive care unit when the unit caught
on fire.
HARRISON: Wow.
IVES-ERICKSON: Which resulted in the necessity, all these
intubated, critically ill patients, needing to be evacuated
while at the same time, we’re trying to protect our
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patients, we were being exposed to a significant amount of
smoke. Because the fire was all Styrofoam, so it was black
smoke everywhere. So, I think that sort of gave -- set
probably the underpinnings of thinking I’m never going to
be in a bad situation again. There are things that one can
do. We did a great job that day, but we could have done a
better job, so why I’m so interested in this. When I came
to the Mass General, and I became a nursing director, I was
being oriented as a nursing director when a large fire
started in what was then the Baker building. A building
that no longer exists, and on the top floor of the Baker
building, the 12th floor were our cardiac surgical patients,
and smoke was rising, and it was a unit that needed to be
evacuated. So, this will bring a smile to your face, so as
everybody’s huddling, and getting directions, somebody
said, “Who’s in charge?” And the person who was orienting,
because on the disaster tree at the time, the position I
was taking was, in fact, the leader of emergency planning
and management. And my preceptor said, “Jeanette is.” I
went, “OK.”
HARRISON: Here I am.
IVES-ERICKSON: Here I am. So it’s -- I think those two give you
background to say all right, if you’re going to be put into
these situations, you’d better know what you’re doing. My
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next big reflection on how to get prepared was in fact
[05:00] on September 11th, where I think the whole country
was preparing to bring victims into major hospitals like
ours, trauma centers, and we began working fast and furious
on how to, if you will, safe passage for the patients that
were in our hospital.
HARRISON: Yeah. To clear room?
IVES-ERICKSON: To clear room for those victims we thought we
were getting. Plus patients who were high up in our
Ellison building were watching television and planes flying
into tall buildings, and they wanted out. So, we think --
and then of course, the FBI is arriving, interviewing
patients, and lots of lessons from that, that one, which is
to take into consideration the patients that we -- we
serve, the community that we serve, the workforce that
consisted of a significant number of people from the Middle
East were frightened. We had patients from the Middle East
who were extremely frightened. But, and so how do you
respond to an emergency, stay true to your values, right?
Making certain that who you are as a person is not jaded.
Or overshadowed by a moment in time. So, lots of lessons
there that while preparation was going on and were not
necessary, certainly lots of lessons learned. I worked a
fair amount in my time here with Dr. Susan Briggs, and Ann
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Prestipino might have talked about this, about Susan’s work
in international disaster response.
HARRISON: OK, yeah. I don’t think anyone’s spoken with me about
that.
IVES-ERICKSON: So, Dr. Briggs is a -- was a trauma surgeon here,
and after the bombing of the Cole, she worked with the
federal government and the State Department to set up and -
- (phone rings) Excuse me.
HARRISON: Sure.
END OF AUDIO FILE 1
HARRISON: [00:00] OK, so you were telling me about Susan
Briggs.
IVES-ERICKSON: So Susan Briggs worked with the federal
government to set up an international disaster response
team. I happened to be -- I was allowed the privilege of
working with her, and it really was a privilege, to select
and train MGH physicians and nurses that became part of
this team, which then became a national model. There are
replications of this around the country. And they respond
to like the earthquake in Iran, where Americans hadn’t set
foot on soil in a very long time, they did in fact go to
New York City on September 11th, that is the one major thing
that we had the privilege of contributing to. So they’ve
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been to disasters around the globe. So all of that has
been, you know, preparing me for that marathon. I did, in
fact, go with Project Hope to the tsunami in Indonesia with
the president of Project Hope and Peter Slavin, so really
got to see natural disasters and devastation. So, this is
an area that’s always interested me. And then, of course,
from a job perspective, being part of our incident command
has been very important, and all of the training that goes
with that. And I suspect Ann talked about the fact that we
had people from Israel here?
HARRISON: Alasdair Conn actually mentioned that, yeah.
IVES-ERICKSON: OK. We -- so we got I would say a wakeup call.
That no matter how wonderful your community is, situations
can change dramatically. So to always be prepared, so I
think it was really the Israelis who helped us to
understand that practicing for an emergency situation, a
disaster needed to become a way of life. And in fact, that
has happened here. So, we’ve had tabletop drills, we’ve
had actual, you know, employees as manikins, if you will,
as the victims. So that we could respond. You just don’t
ever think it’s going to happen. Right? You think being
prepared is a good thing, but you just, you think you’re
never going to need to use these skills.
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HARRISON: Since it’s something a couple people have mentioned, I
should ask, when was it that this Israeli team came here,
do you remember?
IVES-ERICKSON: It was quite a while ago. I can try and find
that out for you.
HARRISON: I just think it’s interesting. A number of people had
mentioned that. So could you tell me what a typical day
looks like for you? Just in general, like what your daily
responsibilities are?
IVES-ERICKSON: Of course from, you know, my job responsibilities
is for really leading the clinical practice of nursing.
But also being a part of the administrative team. So in my
patient care services hat, that’s representing therapists,
social workers, chaplains, interpreters, and lots of
hospital programs, as well as, of course, the 5,00 nurses
of the Mass General. So my day is never the same, which is
why I have the best job at this hospital. Because I can be
in meetings with fabulous people like you where I get to
meet new people, I can be teaching, I have my own program
of research, or I could be out with people making rounds,
visiting patients, helping to care for patients. So every
day it’s different.
HARRISON: Great. I’ve read I think in one of the articles you
wrote that you have a ritual you’ve done in the past on
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Patriots’ Day? I don’t know if you want to talk about that
for the listeners, or if you want to just talk about what -
- yeah, what an average Marathon Monday would look like for
you?
IVES-ERICKSON: So, I went to graduate school at Boston
University, that was in 1987. And since then, I have only
missed one Patriots’ Day. I love -- Patriots’ Day happens
to be my favorite day. I love what happens in Boston, I
love the spirit of the community. I have a ritual of
[05:00] Sunday nights, I cross the finish line backwards.
Because I just love all of the people that are out there
taking pictures, it just is a very positive, it’s a
positive experience. The city is abuzz. And you can meet
people from all over the world, you can just -- I have
photos from every Patriots’ Day of, you know, people like
making, you know, funny poses crossing the finish line on
Sunday, of course.
HARRISON: Yeah. (laughter)
IVES-ERICKSON: People like me go on a Sunday. So, my ritual
changed, I think it’s two years ago, when they changed the
time of the race. But we always went to the Red Sox game
first, would leave generally around the sixth or the
seventh inning, because I loved going to Kenmore Square to
watch the wheelchair race, the first person headed for the
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finish line in a wheelchair. So, since they changed the
time, we don’t go to the game anymore. It’s all about the
marathon. So we usually -- I live right up by the Bunker
Hill Monument in Charlestown, and on Monday morning we roam
the city, out early, have coffee and absorbing everything,
and for the last few years, we have stood in front of the
Mandarin Oriental Hotel. I had it in my head this year
that I wanted to stand at the finish line, on the opposite
side of the street, which thank God I did not do. We went
back to the Mandarin Oriental, and probably about a half an
hour before the first bombing, I said “We’re going to the
finish line.” So we walked around, and we were just coming
out of the Lenox Hotel, because I figured out we could cut
through the Lenox, and end up at the finish line. So we
were walking out the door, standing on the steps, when the
first bomb went off. I don’t know what it was in me, I
knew right away it was a bomb. I’ve never heard a bomb in
my life. And --
HARRISON: What did it sound like?
IVES-ERICKSON: It just, it was this odd sound. I don’t think I
could repeat it. And then we heard the second bomb. My
husband was with me, and we had a very quick, if you will,
huddle. I said, “We need to be smart about this. If we
start to run, we’re going to get injured. But I’m going
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back to the Mass General.” I text my family, said “We are
OK.” I called Ann, I said “I have no idea what’s going on,
but I’m at the marathon and I believe bombs are going off.”
And we walked back to the hospital. And I resumed my
position in the command station. It was -- no, no. It’s
hard to reflect, it’s very hard to reflect. I will be back
at the Boston Marathon this year. My husband,
interestingly, said he’s not going. And so I will be
there. I’m sure it will be an emotional day. But so, we
can talk a little bit about command, and our work. We
probably should talk about sheltered in. And I’m happy to
talk about my time with the patients that week and after.
And then, do you know that we had an MGH nurse who was
injured in the bombing?
HARRISON: I -- Ann mentioned that, and also the -- I think she
showed me a flash mob video that was just created for her.
IVES-ERICKSON: Yes. So I’ve become very close to them. And so,
I’m happy to talk about that they have changed my life,
Jessica and Patrick.
HARRISON: That would be wonderful.
IVES-ERICKSON: OK. So, I think that our command, our emergency
management situation, was very different than we have had
before. Because there was a lot of emotion in the room.
TVs were going, which you have to have TVs going when
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you’re in these -- in the emergency management operations
[10:00] center, because you need to -- it’s the way in
which to know what’s going on. As well as the information
is coming in from the state and from the city that our
police and security department is getting. So, we’re
watching our own city, right? And none of us know who’s
been injured. We know that we have employees at the
medical tent. We know -- employees and family, we know we
have employees and family running. And we know we have
employees and families along that marathon route. I knew
that my number two person, [Marian Didamasse?] was there
with her two sons. And I knew that she was close to where
the second bombing was. So I was trying to get her on her
cell phone. And for a moment, I knew she couldn’t find one
of her children, which scared the daylights out of me. And
yet, I’m trying to do my job. So it’s -- it was very
different than any time we’ve been in, if you will, the
command center. We were all worried about those people
that we care about. And yet we knew we had to do a job,
because we knew patients were coming, and we knew that our
thousand patients and all of our employees were watching TV
wondering what was going on. And would another shoe drop?
The hospital functioned like a well oiled machine. The
emergency department was full. The inpatient units were
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pulling patients out of the ED, patients that were in
inpatient beds knew that if they were going home, they
needed to move a little bit quicker than they normally do.
And it was the best teamwork you would ever see. Patients
were immediately going to the operating room. Patients
were being triaged in the emergency department. And people
were just doing what they had been trained for. It was
intuitive, very intuitive work that they were doing, but
also driven from knowledge and prior experience. You --
the emotions were, I think when you look at people’s faces,
you could see it, but it wasn’t in their actions.
HARRISON: Do you want to talk a little bit more about that? The
sort of, what it felt like, the thoughts and feelings
circulating as everybody was doing their work? How did the
fact that everyone was community members in addition to
professionals that day influence what was happening?
IVES-ERICKSON: You know, you don’t know what was in people’s
heads. But you could, as people were showing up to lend
assistance, you could see relief, “Oh it wasn’t you,”
right? When I walked into the emergency department, one of
the nursing staff who knew I always go to the marathon just
walked over, she was very busy, gave me a hug, and said
“Thank God,” and kept going. So I think everybody was just
worried about would they see someone that they knew.
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HARRISON: As a patient?
IVES-ERICKSON: As a patient. And it was devastating enough to
see these patients, let alone worrying about seeing
somebody you knew. I think the part of the day that went
so fast, I mean it was just like, it went so fast, but then
as the concern built in the city, we have people out there,
suspects, was it one, was it two, was it a dozen? All of
the, you know, the call, there’s going to -- you know,
there’s a suspicious car in the parking garage, we had that
here.
HARRISON: Here, OK.
IVES-ERICKSON: The bomb squad arrives, they -- what was going on
at the JFK Library, right? Another -- so you were trying
to ignore that, but yet you couldn’t. You know, you
couldn’t, because were you preparing for more patients?
Was it going to be in the parking [15:00] garage? Or was
this nervous people, heightened awareness? But even then,
even if it wasn’t anything, it still changed the way in
which hospital operations went. Because the bomb squad is
in the garage, so anyone who wanted to go home couldn’t go
home. Or anyone who wanted to come in couldn’t come in.
So everything that was happening around us was really
influencing the way in which we were approaching our work.
I think for me, the -- I can’t say the biggest thing, but
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for me, that life was never going to be the same again, or
at least that’s what I was feeling that week, was when the
military showed up, and pretty soon, we have people with
rifles in front of Massachusetts General Hospital. We have
SWAT teams everywhere. And I thought wow. Wow, what does
this mean? And it was like reflecting back on what the
Israelis had said. You never know what’s going to change,
and you need to go about your business, but it will be
different. It will be very different. That was like, eye-
opening to me, to see SWAT trucks. The -- you know, the
drive to the Mass General, that ramp, coming up to the
white building, is a very long drive. But when you are
seeing these big black SUVs, and people in uniform with
rifles, it’s very different. It’s very different. And you
-- I, you know, I didn’t know whether to go home after, you
know, all the patients were stabilized, it was late into
the evening, and yet you know you need to be with your
family, but you also didn’t want to leave here, because you
didn’t know, you know, would there be just one person that
you needed to connect with? Several of us ended up going
home, I don’t think I really slept. I know I was -- I, you
know, went home, put my head down on a pillow for a while,
and just got up and came back in. And I think I came back
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in like at two o’clock in the morning, just to walk around,
and see how everyone was.
HARRISON: And at that point, at two o’clock in the morning, what
was the -- you know, you gave us a description of the sort
of feeling during the day, as things were happening, and
the strangeness. But at two o’clock in the morning, what
was the feeling then as you were walking around?
IVES-ERICKSON: One of the things I had done before I went home
was, I went to several of the intensive care units that
were now taking patients out of the operating room, and I
met a family that they just really touched me, they were
very, very upset. And this was a family of a young man,
his fiancée was there, parents, grandparents, he was about
to get married. So it was very emotional. So that was the
first place I went back to. And they were still there, and
it was different, because they were relieved that he was
alive, but you could see really were not absorbing what was
happening, what -- I mean his life was going to be changed
forever. He had massive, massive injuries. The loss of
his leg was one of many things that was wrong with him.
Lots of shrapnel, lots of injury everywhere on his body.
So it was -- and I was thinking, I’m having difficulty
absorbing what has happened to this young man, can you
imagine being a family member? And that was but one. This
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unit had four or five patients that were severely injured.
So at 2:00 in the morning, I just went everywhere I knew
that there were patients, just to see how everyone [20:00]
was doing, and to talk to families, and to make sure that
we were doing what we needed, you know, should be doing.
HARRISON: Is there anything else you want to share about April
15th, that day itself?
IVES-ERICKSON: I think part of -- not on that day did I realize,
but reflecting back on that day, when I -- when we really
didn’t know where everyone was, all the injured and people
were starting to look for the people they were with at the
marathon, you know, families were separated. We really
hadn’t absorbed that, you know, if you and I were standing,
went to the marathon together, and we were standing
together, you could have been in one hospital, and I could
have been in another. So you didn’t totally understand for
quite a few hours, but that was part of the worry that the
patients had. That was incredible. Did anyone discuss the
identification issue of two of our patients?
HARRISON: Dr. Conn mentioned that there was one
misidentification, yeah. But -- yeah. Or he mentioned
one, not that there was one.
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IVES-ERICKSON: Yeah, there was one. So, when we think about
going forward, there are lessons learned. Every time,
there are lessons learned, right?
HARRISON: Yeah, that’s right.
IVES-ERICKSON: So two people, two women standing together, both
injured. First responders take patient A’s pocketbook off
the ground and place it with patient B. Right, and that’s
how one begins to -- and then the FBI is pulling everything
apart, trying to help with what was going on, and trying to
get evidence. And we did in fact misidentify one patient,
and unfortunately the -- it was, one patient had died. And
it didn’t go on for long, but bore the pain from that
still, when people talk about it, it is painful. It is
incredibly painful. People wondering what could have
prevented it. And I’ve gone through every part of that
flow of what happened, and I’m not sure you can. But we
will always reflect on that. It will be in the back of our
mind forever. You know, it goes back to one of the other
disasters that we all participated in, which is the Rhode
Island night club fire. There were no identifiers, you
know, pocketbooks, nobody had IDs on them, or anything.
And, you know, most people were severely injured, head,
neck, arms, hands, I mean you weren’t taking fingerprints,
or you weren’t identifying people. You know, we were
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looking for tattoos, birthmarks, things like that. So,
part of our going forward is how do you take the lessons
from that devastation to think about what people have on
them is not always revealing who they are.
HARRISON: Yeah, right. Are there things that patients or
patient families said to you that have stayed with you that
you want to share? It just occurred to me that this is
about the responders, but that was part of the day.
IVES-ERICKSON: Oh, I was going to go there. The patients
themselves were the most resilient group I have ever met in
my life. One of our patients was incred-- they were all
incredible, but there was one of our patients who said
something to me that stuck with me, that, you know, you
always need to prepare for the unknown. And this was a
wonderful man who was in the Vietnam War. And said, “I
survived the Vietnam War, I never thought in my own
community that I would be injured. I was not ever injured
in Vietnam, but that was a horrific experience, and I will
not allow [25:00] this to change who I am. I came out of
Vietnam a positive human being, and I will go forward a
positive human being.” Each of the patients when we had
the opportunity to bring them together were doing positive
things for each other. I would also say that the families
were unbelievable. Unbelievable. Making not only self-
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absorbed, if you will, which God knows they had every right
to be, but they were always asking about how other patients
were doing. I mean just incredible -- the human spirit was
incredible. And I know, I went to visit patients at
Spaulding, I wanted to see how our patients were doing.
And it was even more evident when they were in rehab, they
formed a new community. And I think Spaulding was
brilliant of placing them all together on the same floor.
Because they have been going through rehab together, they
have been -- they have all stayed connected as far as I
know. And it just, it has given them -- they’ve been able
to help each other in very different ways. I would also
say that one of the things that I was wrong about was all
the community groups that wanted to come and see the
patients. The Boston Red Sox, the governor, the president,
at first I thought oh, this is just too much. They brought
healing. They brought healing to the patients. The Red
Sox were -- they just brought a sense of joy. It allowed a
little levity. They allowed every patient that they saw to
take a photo with them, they were giving autographs. So it
brought something to the patients that I didn’t anticipate
would happen, but the families also. And that to me was
really day one of the Red Sox commitment to these patients.
I mean, look at what happened all year long too, this
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wasn’t just a one-time event, they stayed very true to
these patients and families. There were people --
Congressman Kennedy, I will never forget him, he came in
and saw patients that could be seen at the time. He had
very personal moments with them. The very next day, I got
gifts from him to -- and every gift was different. It was
different things that the patients said that brought them
joy. I had a signed Boston Celtics basketball for one
patient, I had gift cards to their favorite restaurants for
other patients. And I just think about that whole spirit
that emerged. I would say the part that I didn’t
anticipate after the first day was the second day to learn
about one of our own nurses being injured. And of course,
I’m thinking oh, why isn’t she here? And then when I
realized her husband was in an absolutely different
hospital than she was, I reached out to colleagues, one was
at Boston Medical Center, the nurse, Jessica. Her husband
Patrick was at Beth Israel Deaconess. The president of
Boston Medical Center is a personal friend, she used to
work here. And I called her, and I left a message, and she
was, “I’m all over it” was the message back, “I will get
back to you.” She went and saw Jessica every single day.
The night that -- after she learned that one of our nurses
was one of her patients, she said, “I know you well enough,
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you want her transferred to you.” I said, “Of course I do.
But we need to do what’s best for Jessica.” And it wasn’t
[30:00] what was going to be best for Jessica to come to
the Mass General. But I said, “I want to send nurses over
to take care of her.” And her own unit organized a 24 by 7
coverage, a nurse from oncology was with her every single
day that she was hospitalized. Our nurses went and checked
on her husband at another hospital. Our nurses, along with
the administrators of Boston Medical Center and the Beth
Israel organized an effort where we got Jessica in an
ambulance a few days after -- it might have even been two
weeks after, to go by ambulance to see her husband. The
people at Spaulding organized it that they could be in
connecting rooms, so that during the day, they could do
their rehab together when it was appropriate, they could be
together, that they would be together as a married couple.
The MGH community, the outpouring of what this community
did for them, and for all of our patients, but Jessica
hadn’t worked here that long, and we knew that her recovery
was going to be long. The hospital took care of her
medical bills. And the workforce donated almost four years
worth of earned time so that she will be paid, should she
not work for four years. Our social work department got
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them a handicap accessible apartment after they were
discharged from Spaulding. It was MGH at its best. Our
board of trustees honored them. I’ve had a wonderful time
with them. They are two of the most positive people that
you will ever meet. Both lost a leg. Both are still in
rehab. But they will not allow negativity to surround
them. It’s all about going forward, their life has
changed. Their new dog Rescue, do you know about Rescue?
I need to get you an article about Rescue. Rescue is a dog
that was trained by prisoners. And really is the person
that keeps them, I would say functional. They only have to
say, “Rescue, turn the lights on,” and Rescue’s been
trained to walk the wall to turn the lights on. Rescue
brings them their prosthesis when they wake up in the
morning. Yeah, it’s a wow. You could do a whole part of
this on the training of Rescue, and the impact on people
like Patrick and Jessica.
HARRISON: Where is that service coordinated through?
IVES-ERICKSON: The -- Rescue, I think it’s Rescue Eight out of
the Worcester Fire Department. Yeah, it’s incredible. The
part that we -- we haven’t talked about a couple of things.
One which is the -- that horrible Friday of being sheltered
in. I don’t know why, when I reflect back, it feels worse
to me. And I think it was the unknown. And we certainly
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hadn’t practiced any of that. So, it was another, you
know, day of that week of getting up really early, and
getting ready to come to the hospital when I woke up, and I
think it was like three or four o’clock in the morning, and
I’m reading emails that I couldn’t make sense of. So I
called the hospital, and I was told by the nursing -- night
nursing supervisors that a hunt was on for the terrorists.
And so, I said, “I’m on my way.” And as my husband, bless
him, is driving me here, because he says, “You’re not
taking a taxi.” We’re driving the dark streets of Boston,
and I said, “What are we doing?” [35:00] So you hadn’t
trained for that, right? So, you feel like your job, which
it is, is here, but that might not have been the safest
component of that, but I would have done it anyway. We
would have done it anyway. And I started calling people to
say I’m here, you need to stay home, you’re in a zone
that’s deemed unsafe, and person by person said, “That’s
nice, but I’m coming in anyway.” I know very few people
who stayed home. They were here to take care of their
patients, or they were here to take care of their staff.
And so that became a very different day. It was a day
where we were writing, I would say, a new chapter for our
emergency management system. We were nervous, but for a
different reason. It was the unknown, how many doors do we
24
have open at the Mass General, or the -- is the military
out there, still there with their rifles? We hope so.
HARRISON: You mean wanting them there?
IVES-ERICKSON: Yeah. All of the sudden we wanted them there.
What does that mean? And lots of hysteria in the media.
Which -- and no rules, right? Absolutely no rules. And
then, all of the sudden, it was over. All of the sudden,
we’re looking out, taxis are going by, we’re hearing public
transportation is being reinstated, and the shelter in
process is over. They’re still out there, what did it all
mean? So, many of us are looking at ourselves, saying what
does this mean? Should we go home? Should we stay? We
stayed for a while, we made a decision to go home. As
we’re on our way home, we’re -- some of us were home, glued
to the television, wondering why we went home, watching
that there’s a shootout happening. We are all starting to
get ready to come back to the hospital. We had a lot of
misinformation about where they were being taken. Once
they were, emails, communication, it was just totally
emotional. It was totally emotional. We still did really
well as an organization, and I think it goes back to being
prepared, using our years and years of experience as
clinicians and administrators, but it was new territory.
It was new territory.
25
HARRISON: I was going to ask what the -- you know, as staff were
talking with each other and communicating with you at this
level, caring for patients, still the priority, what was
the discourse among staff at that time though, with all
this uncertainty? How did you communicate with patients,
how did you communicate with each other?
IVES-ERICKSON: So, we -- I think we communicated more than we
ever have. We were having lots of meetings, lots of prayer
services, lots of email communication. Dr. Slavin, Dr.
Torchiana sending out updates, letting people know. We did
get feedback from people that we did not communicate
enough.
HARRISON: Oh. People outside the hospital?
IVES-ERICKSON: No, in our own workforce. And it only goes to,
right, the uncertainty. And never having been in this
situation. So I think, you know, having spent hours upon
hours in the hospital was the right thing to do, but it’s a
lesson learned that no matter how much you feel you’re
touching people, in this time of uncertainty, you can’t
touch them enough. That the workforce needs more, because
they were busy taking care of patients, and so you have to
-- how do you do that balance of infusing them with the
information that you know at the time, but also making
certain that the information you’re giving them is
26
accurate? Because there was a lot of misinformation out
there.
HARRISON: That’s right, I remember that.
IVES-ERICKSON: Right. And so, I think it’s more the rounding,
and we’re OK would be, for me, as one of the leaders,
[40:00] is to be as visible as possible.
HARRISON: You said that that day, the 19th, was the day that a
new chapter was written in emergency response. Did I get
that right, what you said?
IVES-ERICKSON: I think being sheltered in was, it was a new
chapter for me. When we -- when I think about disasters,
my mental model is open and bring us your injured, bring us
the victims, and we will help. Sheltered in, the message
was not so fast, right? We need to protect those that are
already here, and for those of you that want to come here
for routine appointments, we really don’t think it’s a good
idea. When -- so when I say a new chapter, when was the
last time a care provider purposefully said to a patient,
“I don’t think it’s a good idea that I take care of you
today?” And it wasn’t about me taking care of the patient,
it’s making certain the patient stayed home and was safe?
We’re not accustomed to that. Our way of being is come,
and we will offer you great care, we will offer you hope.
We’re saying, we think you’re better off at home.
27
HARRISON: Right. So that might be a way or a time to transition
into talking about sort of the weeks that followed, the
months that followed. If you, in your position, saw
changes happening in the way everyday life, everyday work
was happening at Mass General after the marathon, or ways
that you saw the lessons learned becoming infused in the
culture or the policy around here?
IVES-ERICKSON: Less about policy, and I would say more about
advocacy. So one of the things that I learned, especially
from Jessica and Patrick, is that we -- when we think about
amputations, we generally are thinking about planned
amputations. We are not thinking about the amputations
that are happening in Iraq and Afghanistan. And so, as a
healthcare community, you know, when we think about
prostheses, we think about ongoing care. We had
opportunities to learn, and I -- so I -- my message of
learning is how does the public, the healthcare sector,
partner with groups like the military? And when we think
about other countries, we’ll use Israel as an example,
there is that relationship between healthcare and the
military. There isn’t that connection of the US military
with the healthcare system. And I think the military and
the US government could have been very beneficial in the
aftermath, not the immediate, but the perhaps three months,
28
six months, one year later. Because the military has been
dealing with these traumatic amputations. So for me, I
think it’s a wonderful thing, and I had the opportunity to
meet with representatives that were hired by Massachusetts
to look at what would we improve in our response? And that
was one of the things that I brought forward.
HARRISON: I see, sure.
END OF AUDIO FILE 2
HARRISON: [00:00] OK.
IVES-ERICKSON: So, I think this is, for me, one of the major
lessons is that there are people in our society that have
different experiences. And so, how do we bring groups
together that we would -- that aren’t -- in our current way
of being, aren’t logical in our thinking?
HARRISON: You mean people who might share experiences across
groups that don’t usually mix?
IVES-ERICKSON: Might share experience, right.
HARRISON: And when you talk about these unexpected amputations,
are you thinking about sort of the psychology of learning
that? And coming -- adapting to that reality, or?
IVES-ERICKSON: Or even the -- it’s more about the care of these
patients. These were horrific amputations that in our way
29
of thinking, you would have seen if somebody stepped on a
landmine in Iraq or Afghanistan. They’re not ways of
thinking about an amputation in Boston, Massachusetts. And
so, what about the prosthetics? What about the
rehabilitation? What about the amputees that needed
revision surgery? It -- to me, it would be a wonderful
contribution to how, as a society, we go forward.
HARRISON: That’s very thoughtful. And were any outreach -- was
there any outreach made between the health sector and the
military with this?
IVES-ERICKSON: So, a little bit. I think we’re going to see
more to come in this area. It’s -- I’m not aware of what
is happening, but it is, in fact, one of the things when
the president was here, he was talking about.
HARRISON: And has the hospital changed its disaster policy in
any way?
IVES-ERICKSON: There are discussions, revisions, things that we
need to think about going forward.
HARRISON: OK. I feel like we’re coming to the end of what I
wanted to ask you about explicitly today, and I wonder if
there are other things that you want to talk about that we
haven’t touched on?
IVES-ERICKSON: You know, we talk about the details, and the
horrific nature of all of this in our city, but if we think
30
about resiliency, we even think about what the city is
planning to do this year on April 15th, it speaks volumes to
the human spirit. The fact that there are more runners who
are going to run the Boston Marathon this year talks about
that community spirit. The commitment that we all felt
from the rest of the world, the rest of the country, I mean
there aren’t even any available hotel rooms in Boston for
this year’s marathon. So, it says a lot, and I have to
tell you, if you go to the Russell Museum, there were gifts
that came in from across the world. I got emails from the
people that I work with in China, I got emails from nurse
leaders from around the country, school children who were
making posters for the patients. Quilts, quilting groups
that came together, every patient here received a gorgeous
quilt from quilting groups. Food from everywhere.
Expressions of how can we help. So, it all goes back to
the takeaway message is that the negativity of this was
horrible, but it was a moment in time. What we need to go
forward and remember is the resiliency, the community, the
sharing, and I would say the gifts that people brought to
the moment.
HARRISON: OK, thank you.
IVES-ERICKSON: And I got to hold the president’s hand so, I
mean, you know. (laughter)
31
HARRISON: That’s always a good thing.
IVES-ERICKSON: I don’t know what overcame me, he was standing
behind me and I went like this, and I have a picture of me
holding his hand. It’s great.
HARRISON: It sounds like it was actually just a really special
[05:00] presence that day.
IVES-ERICKSON: He was special. He was incredibly special. This
was not the -- I mean there were lots of photo ops. But
this was not for him a photo op. When he went to see a
patient, he went by himself. And it was a personal moment
between the president of the United States and the patient.
And after he saw each patient, he was great. He said to
all of the doctors and nurses, and support staff on each of
the units he went to, “Anybody want to have a picture taken
with me?” So he was fun, but he was thoughtful with -- he
was incredible with the patients. I’ll always remember the
patient who said, “You probably don’t want to see me, I
didn’t vote for you. I’m a Republican.” And the
president, without thinking, said “Today, we are all
Americans.”
HARRISON: Yeah.
IVES-ERICKSON: Yeah, he -- yeah, he was great, he was great.
The patients --
HARRISON: That’s great. All right.
32
IVES-ERICKSON: -- were provided a teaching experience.
HARRISON: Yeah.
IVES-ERICKSON: Yeah. It was good. So, I’m going to get the
Russell Museum information for you. I’m going to try and
find out the dates of our Israeli training.
HARRISON: OK. And that’s great. And is there anything else you
want to say before I turn off the recorder?
IVES-ERICKSON: No, you’re great.
HARRISON: Oh, that’s nice.
IVES-ERICKSON: You’re doing a great job.
HARRISON: Thank you.
IVES-ERICKSON: Yeah, you made -- no, you made every -- it was
good.
(laughter)
HARRISON: OK.
IVES-ERICKSON: It was good. Tell Scott you got an A plus.
(laughter)
HARRISON: Thanks. All right, signing off.
END OF AUDIO FILE